For Sandra Beasley, eating the wrong thing could be catastrophic. The poet and author has severe food allergies that can bring on anaphylaxis, a potentially life-threatening allergic reaction. Find out how she learned to deal with food while living a fulfilling life…

For Sandra Beasley, scary things come in tiny packages: a cashew, a shrimp, a pine nut.

That’s because she fears anaphylaxis – a life-threatening allergic reaction caused by certain foods, medications or insect venom. Being exposed to the wrong thing could send her to the hospital – or kill her. Even kissing someone who just ate ice cream is dangerous.

The award-winning poet, 34, should know. Her food allergies first appeared when she was an infant – she got an upset stomach from her mother’s breast milk. Today, the list of foods she’s allergic to is long and includes:

Dairy products

Eggs

Soy

Beef

Shrimp

Pine nuts

Cucumbers

Cantaloupe

Mango

Macadamias

Pistachios

Cashews

Swordfish

Mustard

About 15 million Americans have been diagnosed with food allergies, including about 1 in 13 U.S. children, according to the nonprofit group Food Allergy Research & Education. The foods that most often cause severe reactions are peanuts, tree nuts, fish and shellfish, resulting in more than 200,000 emergency room visits per year.

In this exclusive interview, Beasley tells Lifescript how she navigates life, knowing that a bite of the wrong food could be lethal.

Your book title, Don’t Kill the Birthday Girl, is catchy. What does it mean?
I always wanted to have celebratory meals on my birthday, like ice cream or pie. I wanted to see everyone light up with those foods.

After the others ate the good treats, I had to be careful not to be touched or kissed, which could cause an allergic reaction. It was hard to get it on everyone’s radar that touching me was dangerous. My mother coined that phrase, and lots of people in my life adopted it: “Don’t kill Sandra.”

Do you take the same precautions on your birthday now?
I don’t have to. Today, people with dietary restrictions can have treats that taste normal, familiar and fun, such as gluten- and dairy-free foods. In the ’80s, those materials weren’t widely available.

I love that guests won’t talk about certain things that aren’t on the menu; they’ll just talk about how good the food is.

How were your many allergies discovered?
In the first month of my life I lost weight; I was malnourished and miserable. Doctors knew that was a sign of intolerance or allergy. Breast milk and formula passed straight through me. I was diagnosed with a broad range of allergies, which would be specifically determined later.

My immune system was too underdeveloped to show a typical reaction.

My poor parents discovered my allergies one food at a time. I started out [drinking] apple and pineapple juice with an added dietary supplement. When I was ready for partial solids, I did very well with cereal and puréed chicken. Then they added fruits and veggies, like carrots and potatoes. I had a very simplified, repetitive diet.

How did you navigate all the food land mines at school as a child?
I brought lunch to school every day. I knew that if the school served fried potatoes, I could eat them; my mom checked with the cafeteria staff to make sure they were safe.

But parading past all the foods I couldn’t eat to get to the one I could wasn’t fun. And I wondered whether a worker first used the tongs for the potatoes to serve foods I couldn’t eat [which could cause dangerous cross-contamination].

My mom always loaded my lunch bag with plenty of treats, because I couldn’t eat birthday [cake] or use school vending machines. I had lots of things to enjoy or give away.

But I remember sitting out my class’s “Green Eggs and Ham Day” activities because I couldn’t eat the eggs.

Did you eat out when you were growing up?
By and large, eating out wasn’t a part of my childhood or teenage years.

In middle school and high school, kids with allergies have to learn the lessons of [food] navigation. If a larger school group did go out, I’d eat beforehand and just drink a Coke at the restaurant.

Still, despite all the precautions, you do get hurt sometimes.

What happened when you ate new foods?
I became more adventurous about food in college. I remember trying salmon sushi. It went great – no reaction. I went to the same Japanese restaurant and ordered the same exact roll countless times. They called me “Salmon Girl!” It felt safe and luxurious.

But I also discovered new sets of allergies.

Today, trendy foods suddenly show up in restaurants. For example, I went years not even knowing I was allergic to mango. But now it’s on sushi and in McDonald’s drinks. I had to learn really fast.

I still discover a new category of allergies about once a year. I now know I can eat mussels, oysters and crabs. But I’m suspicious that lobster is close to shrimp, which I’m allergic to, so I’m staying away.

Which of your allergies triggers anaphylaxis? How do you handle that?
Dairy products cause an anaphylactic reaction. So do shrimp and cashews. It takes just a minuscule amount of these foods to set me off.

My initial reaction always used to happen in the back of my throat – itchiness and then [my throat] started to close. Now my eyelids swell. Your body changes over time.

Today, my [anaphylactic] reactions to foods include swelling, difficulty breathing and vomiting. When I was a kid, you had to pass out and experience a drop in blood pressure for it to be considered [anaphylactic]. The attitude was more wait-and-see, and then manage it with [an antihistamine].

I’ve been taken to the hospital and treated with epinephrine, when I should have used an [auto-injector] when I first felt the symptoms.

[Editor’s note: In an allergic reaction, chemicals called histamines cause a runny nose, itchy eyes and other symptoms; antihistamines such as diphenhydramine block them. If an anaphylactic reaction occurs, the patient or a caretaker can use an auto-injector to deliver a dose of epinephrine, or adrenaline, to the bloodstream; it quickly stops the drop in blood pressure and makes breathing easier.]

Do you recall an especially scary occasion?
In 2011, I was in Miami for an artist’s residency, staying with a nice restaurant owner and his family. The owner gave me a vegan wrap – safe food! But instead of the tahini sauce [made from sesame seeds] I thought I was using, it was cashew sauce.

As I walked to my car, I had a huge reaction, including nausea. I was by myself, far from home, and decided to get near people who might help. I texted a friend and then drove to a nearby hotel’s valet parking area. As the valet approached, I opened the car door and vomited. I told him I wasn’t drunk, I was having a medical emergency.

My friend got my text and rushed me to a medical facility.

What do you typically do when you have an anaphylactic reaction?
If I’m at the level of needing [an antihistamine], I immediately alert someone in the room that I’m in medical distress. I used to hide it. Even if I try to control it with the antihistamine, I speak up.

If the antihistamine isn’t working, I make sure that someone within 2 feet of me has an [epinephrine auto-injector]. And I make sure that person knows how to handle it. If I have difficulty speaking clearly, if my throat is closing, I have them call an ambulance.

Where do you keep your medications?
I carry my antihistamine and [auto-injector] with me from room to room in my purse. I’m never without them.

Are you ultra-careful about what you eat?
Yes! If I’m at a reception, I do a constant mental cataloging of food exposures. I keep track of who’s eating from the cheese-and-cracker platter to know who I can get close to. At the end of a holiday party, if I see someone drinking eggnog and then she comes over to give me a kiss good-bye, I have to decide whether to risk it. Sometimes, rather than explaining why I don’t want that, I’ll take a chance and let her.

There’s a difference between being hypervigilant and extreme. Be aware of the risk and decide whether to take it.

How do you handle going to a friend’s house for dinner?
I always talk to the hostess ahead of [my arrival]. I let her know about my allergies.

If I’m in a group of six or less, the hostess usually is delighted to have the challenge of coming up with a menu that accommodates my allergies. If it’s a larger group at a dinner, I find what foods are being served; I’ll contribute one dish that goes well with the others and I know is safe for me.

I always have a backup plan. [For example,] I keep crackers in my purse.

How do you prevent an anaphylactic reaction at a restaurant?
If I’ve eaten at that restaurant a lot and know the menu, I’ll order and relax.

If I’m going with a large group, I call the restaurant in advance. They’ll set aside things for me to eat. In the past, many chefs wouldn’t accommodate me. Today, many do.
If it’s a place I’ve never been to, I look at the menu ahead of time, have dishes in mind that I want to order and explain my needs to the kitchen. I’ll go with whatever is safe.

Has coping with allergies become easier over time?
Much easier. I feel so much more empowered to live the life I want to live, eat what I want to eat and socialize around food.

But the vulnerability when I have a reaction is as bad as ever. And I fundamentally view food differently from everyone else. For example, when my friends decide to stop off at a pizza place or ice cream shop at the end of a night out, [it hits me]. All night we’ve been enjoying the same music, same baseball game, sharing pitchers of beer. From then on, though, there’s no enjoyment for me – only anxiety at coming into contact with [allergens].

What’s your advice to those coping with food allergies and anaphylaxis for the first time?
Know you’ll experience tremendous fear and that the allergies will redefine your life. There will be a learning curve and some difficult moments when you have to recalibrate what you can do and how you do it.

No one has to be defined by their food allergies, though. I have so much joy and companionship in my life, even while toeing the line with my allergies. You can too!

What’s Your Allergy IQ?Ignorance may be bliss, but not when it comes to a stuffy, sneezy, scratchy problem like allergies. Maybe you suffer from seasonal allergies. Or perhaps the bed bugs really are biting. Do you know what’s making you itch? Find out with this allergy quiz.

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